COVID-19 has had a disproportionately heavy toll on U.S. communities of color across income levels, according to a new research letter published in JAMA Network Open. Poverty is one of the clearest consequences of structural racism, and one of the easiest to link to health inequity. You can trace an unbroken line from racist real estate and employment policies to the struggle of many Black and brown families to afford things like fresh food, insurance and quality medical care. These disadvantages always have a direct impact on health—but especially during a pandemic. The new study, however, shows that structural racism affects health in ways that go beyond poverty. “Income is one feature that’s important,” says senior author Andrea Troxel, director of the division of biostatistics at the New York University Grossman School of Medicine, “but there are so many others.” Troxel’s paper drew on publicly available data from counties surrounding 10 of the country’s largest urban areas. The researchers first sorted the counties into those with relatively high and low rates of poverty. The median income across high-poverty counties was about $60,000, compared to about $80,000 for low-poverty counties. Next, the researchers looked at the racial makeup of each county, along with the local incidence of COVID-19 infection and death through May 10. They found that people living in substantially non-white communities were significantly more likely to contract and die from the novel coronavirus, no matter how affluent their community. COVID-19 death rates were about nine times higher in lower-income, predominantly non-white communities, compared to lower-income, mostly white communities, according to the study. Even in richer areas, coronavirus death rates were almost three times higher if the county was predominantly non-white, versus heavily white. Disparity is “very pronounced in counties with higher levels of poverty, but it’s certainly present in the lower-poverty counties as well,” Troxel says. “That was a little bit of a surprise to us.” Troxel’s team didn’t have access to household-level data, so the paper couldn’t assess granular factors like how much money an individual family made, how many people lived in a specific home or how easily a family could secure medical care. For that reason, she says, it’s impossible to say exactly what’s behind the disparity the research team observed. But this isn’t the first time research has shown that race-based health disparities persist even in higher-income populations. One 2017 paper looked at the health of people making at least $175,000 per year. Even in this wealthy group, the researchers found that Black Americans experienced worse outcomes than their white peers in six out of 16 categories, including prevalence of diabetes, high blood pressure and physical inactivity. Hispanic Americans were disadvantaged in three categories, including rates of obesity. “Even among those with high income, blacks and other minorities are unable to escape discriminatory treatment,” the authors of the 2017 study wrote. This could have a direct impact on wellness, since studies have shown that the stress and trauma of discrimination may put people of color at higher risk for physical and mental health issues. When it comes to COVID-19, the type of job someone holds also matters—probably as much, if not more than, their salary. Someone with a desk job that lends itself to working from home has a much lower chance of exposure than an essential worker who must physically report for duty each day. Data show Black Americans disproportionately hold essential jobs in fields like transportation, health care and child care. Troxel says she hopes her research, though preliminary, will encourage lawmakers to address health inequity at a policy level, and to examine it with the nuance it deserves. “It’s not a question of biology or some sort of innate susceptibility [to disease],” she says, “but a question of [how] the racism of structures and the history of our society has developed to the extent that it goes well beyond income.” from https://ift.tt/39ED5DN Check out https://takiaisfobia.blogspot.com/
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In July of any other year, many of us would be starting our mornings catching up on the score of last night’s game, or checking in on the stock market. But in 2020, the most important number—the one we all want to see every day—is how many new cases of COVID-19 struck the country and the state where we live in the past 24 hours. The trouble is, there’s so much information available—much of it inconsistent or incomplete—that it can be difficult to quickly get a clear read on how dire the coronavirus pandemic is today compared to yesterday, or two weeks ago, or three months ago. In an effort to reduce the noise, TIME has developed a one-stop dashboard that condenses all the available data into as concise and informative a presentation as possible. The dashboard is built off of essentially the same metrics that, as journalists who have spent months combing through the numbers, we find most useful in informing TIME’s reporting on this unprecedented crisis. We figured that, so long as we’re already spending untold hours calculating the clearest picture possible, we ought to publish the results for anyone to examine. Beginning today, we’ll be updating the page every morning with the latest figures from the previous day. The first thing you’ll see on this page is a small “snapshot” showing the total number of cases and fatalities both globally and in the U.S. and, more importantly, how much those figures have grown both in the previous day and over the past two weeks—roughly the incubation time between when a person is infected and when they are likely to show any symptoms. This section also includes a list of every state that has recently reported a new daily record-high number of infections, landmarks that frequently make headlines. As you scroll down the page, you’ll see the rise and fall of new cases in every state and the U.S. at large, as well as which states are currently responsible for the largest percentage of new cases in the country. The state-by-state comparison, we’ve found, is one of the most important means of understanding how the nation is faring because the situation on the ground looks very different depending on where you live. While the nationwide figures for infections and deaths might be the most commonly cited metrics, those U.S-wide numbers are largely made up of only a small handful of states. And which states those are has changed repeatedly since the pandemic took off in the U.S. in early March. Finally, the dashboard includes a map and list showing the toll—both in raw numbers and on a per capita basis—of COVID-19 on every nation and sovereign territory. We’ll be adding modules to this dashboard as new metrics emerge that we find to be essential in navigating this pandemic. Feel free to send us suggestions if there is a particular metric you have trouble finding and would like to see—bearing in mind that the data are constantly trying to catch up to reality, just like we all are. We hope this dashboard can help. Click here to see the full dashboard. from https://ift.tt/39BTvwP Check out https://takiaisfobia.blogspot.com/ (WASHINGTON) — U.S. health officials are warning Americans again to avoid a growing list of imported hand sanitizers that may be contaminated with the toxic chemical methanol. The Food and Drug Administration said Monday there have been increasing reports of injury due to people using— sometimes ingesting—the unauthorized sanitizers, which can lead to blindness, heart problems and death. The active ingredient that kills germs in legitimate sanitizers is ethyl alcohol, which is consumable. But some Mexican companies have been replacing it with poisonous methanol, or wood alcohol, which is used in antifreeze. The FDA first issued a consumer warning about the products last month. Last week the agency issued a warning letter to Mexican manufacturer Eskbiochem SA de CV for marketing sanitizer containing more than 80% methanol and falsely claiming that it was “FDA approved.” The FDA has posted a “do-not-use” list of more than 80 sanitizers on its website and blocked their importation. The agency said it is working with retailers to recall products remaining on U.S. store shelves. The illegitimate gels generally don’t list methanol as an ingredient on their packaging. from https://ift.tt/3fbW3Tj Check out https://takiaisfobia.blogspot.com/ Modernas COVID-19 Vaccine Enters Final Testing Phase As Researchers Dose the Studys First Volunteer7/27/2020 Moderna Therapeutics and the National Institute of Allergy and Infectious Diseases (NIAID) announced today that researchers had injected the first volunteer in the first coronavirus vaccine to reach the final, phase 3 stage of testing. That person received the shot at 6:45 am eastern time in Savannah, Geo., Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) told reporters during a briefing. Because the trial will randomly assign participants to receive either the vaccine or a placebo, and neither the researchers nor the volunteers will know which they received, that person won’t know until the data is unblinded whether he or she was vaccinated against COVID-19. Ultimately, 30,000 healthy people will be immunized either with the vaccine or a control to determine how effective the shot is in preventing COVID-19. “The collaboration between the NIH and Moderna, with much support from Operation Warp Speed has now reached a point where we have a chance to find out in the real world…what the status of the vaccine is in its ability to protect against disease and be safe,” said Dr. Francis Collins, director of NIH. Moderna is one of a handful of companies receiving federal funding through the government’s Operation Warp Speed program to facilitate development of a COVID-19 vaccine. Because this final phase of testing will focus on how well the vaccine works, as opposed to the earlier stages which concentrated on making sure the vaccine was safe, the researchers say they will make an effort to enroll volunteers who are more likely to be exposed to the virus. That includes people in high-risk occupations such as health care workers, as well as people in areas of the U.S. where the virus is currently spreading rapidly. The current network of 89 trial sites matches up with areas of the country where the virus is now spreading, said Fauci. “I think we will get a good sampling where the activity of the virus, or transmission, is currently going on in the country,” he said. That’s important because the more people who volunteer in areas where the virus is actively circulating, the more likely those participants will be to get exposed to the virus. That would help the researchers more quickly determine whether people who were vaccinated with the experimental shot had better protection in fighting infection than those receiving placebo. Already, said Collins, a website created to invite people express interest in enrolling in a trial has attracted 150,000 registrants. Not all will qualify for the trial, but it’s an indication of how much interest and willingness there is to participate, and how quickly the trial will reach its target of volunteers. If the virus continues to circulate widely, Fauci estimated it might be possible to get a first pass of results as early as November. That timeline accounts for the few weeks it will take in July and August to reach the goal of enrolling 30,000 eligible volunteers, as well as the time for people in the study to receive the second dose of the vaccine, which comes 28 days after the first, and time to analyze the data. “It’s certainly conceivable that if we have a real blast or rash of infection in those sites in which we do have active enrollment, then we might get an answer earlier than November. I doubt that but we are leaving open that it is a possibility,” he said. Moderna and NIAID scientists collaborated to develop the vaccine using a relatively new technology based on mRNA, which contains the genetic instructions for making proteins. The vaccine includes mRNA that codes for the spike protein for SARS-CoV-2, the virus that causes COVID-19. Once people are inoculated, their immune cells recognize the foreign, viral mRNA and start mounting immune responses against it. In theory, then, if they are later exposed to the actual virus, their immune system will be prepared to fight it off. In earlier studies, the vaccine triggered antibodies against the virus at levels similar to those found in people who were infected and recovered from the disease. Further tests showed that the antibodies made in response to the vaccine could neutralize lab-versions of SARS-CoV-2. The newly begun phase 3 trial would be the real-world test of how the vaccine works when confronted with the virus. At the moment, that test will be deemed successful if the vaccine is 60% effective in preventing people who are vaccinated from getting infected with SARS-CoV-2. That’s not as potent as vaccines such as that for the measles, which is 97% effective, but “together with public health measures, [it] would be a major, huge step toward controlling this outbreak at the domestic and global level,” said Fauci. “I’d like to see more than [60%] but we’ll take that amount.” Researchers will track volunteers for one year to see if they develop any side effects, and the scientists will also continue following them to track their immune responses for another year to learn more about how long the immunity provided by the vaccine lasts. Stephan Bancel, CEO of Moderna, said the company has already begun to manufacture doses of the vaccine in anticipation of a positive result from the trial. “We are ramping up manufacturing…and are well on track to deliver 500 million doses in the 2021 fiscal year,” he said. “The team is working hard to manufacture close to one billion doses next year, and I think that one billion doses will be doable. It’s not in the bag yet, but the 500 million I think is in the bag for next year.” The company has received close to $1 billion in federal funding from the Biomedical Advanced Research and Development Authority to develop its vaccine and complete its final phase of testing. Collins said that a group of public health experts are working on how to distribute those first doses if and when they are deemed safe and effective. “There will be tens of millions of doses at the time the vaccine is determined safe and effective, [but] there won’t be enough for everybody,” he said. “Decisions will have to be made on who will have priority.” He said the Centers for Disease Control’s (CDC) Advisory Committee on Immunization Practices, along with a specially convened panel of experts from the National Academy of Medicine, will provide guidance on how to prioritize groups who need the vaccine. “We recognize that COVID-19 has put into sharp relief the health disparities that afflict populations in the U.S. where hospitalizations, serious illnesses and deaths have disproportionately fallen on the shoulders of African Americans, Latinx and Native Americans, and we know this disease is also a particular danger for older people and people with chronic illnesses,” Collins said. “Therefore if we wish to demonstrate the safety and efficacy of this vaccine, we particularly want to be sure those groups are well represented in vaccine trial enrollment.” The National Academy panel is expected to provide interim distribution guidelines by Labor Day, which would then be open to public discussion, and would then form the basis of recommendations that the CDC’s advisory committee hopes to have ready by the end of September. from https://ift.tt/2D8MxDh Check out https://takiaisfobia.blogspot.com/ It was the Chinese philosopher Sun Tzu, and not Al Pacino in The Godfather Part 2, who first said, “Keep your friends close, and your enemies closer.” Yin Weidong, the CEO of Chinese biotech firm SinoVac, seems to have taken that advice to heart. On the desk in his office in Beijing are two plastic models of a virus—each blue core surrounded by red protein spikes. From the time it started spreading in the central Chinese city of Wuhan in late December, containing that virus has occupied virtually every waking moment for the scientist. The pandemic we now know as COVID-19 is rampaging across every continent. On the dozens of daily infection charts, broken down by nation and pasted floor to ceiling on Yin’s office wall, the numbers tell a horrifying story: 16 million infections and 640,000 deaths worldwide, including 146,000 American lives lost as of Monday. But if the enemy is close, so is a possible new friend. Yin’s desk is now also home to several small glass vials of SinoVac’s COVID-19 vaccine—dubbed CoronaVac—that began phase 3 trials involving 9,000 volunteers in Brazil last week. (A phase 1 trial involves small groups of patients to check a vaccine for negative side effects, and a phase two trial usually tests for a combination of safety and efficacy, while a phase 3 trial is like a phase 2 but involving many more participants.) “Looking at the data collected, I think we have more than an 80% chance of success,” says Yin. Normally, getting from pathogen identification through phase 3 trials in about 10 years is considered quick. The mumps vaccine is generally considered the fastest ever developed at four years. But if all goes well, CoronaVac might be ready for regulatory approval early next year. Not that Yin is satisfied. “Do you really think this is fast? Compared with the spread of the virus, it’s not fast enough,” he says, holding his plastic nemesis aloft with grudging respect. “That is how we should measure our progress.” During the 2002 to 2003 SARS outbreak, which claimed over 774 lives worldwide, SinoVac was the only firm to go into phase 1 vaccine trials, but the pandemic suddenly disappeared. That meant that research was discontinued at a huge loss for the firm. It wasn’t entirely wasted, however. Now, 17 years later, SinoVac is able to build on that earlier work, given that COVID-19 is very similar to SARS. It and coronavirus are “like brothers,” says Yin. Still, creating an effective vaccine is just a third of the battle. The other two prongs of vaccine development are production capacity and getting regulatory approval. At present, every nation’s FDA equivalent would need to approve CoronaVac independently, though given the unprecedented need, there are conversations about streamlining. “The virus doesn’t require a passport but the vaccine needs to be licensed by every country,” says Yin. SinoVac is aiming to triple current capacity to produce 300 million doses per year. That might sound impressive, but accessibility is likely to be a big issue. Given that at least two doses will be required to immunize one person, it would still take almost a decade to vaccinate every person in China alone, never mind sharing the virus with the world’s 7.6 billion people. “If only one or two countries get protected this won’t solve the problem and get economic activity back to normal” Yin says. SinoVac isn’t the only company with a potential vaccine in clinical evaluation. There are over 20 companies around the world engaged in the task with more than 130 vaccines in development, according to the WHO. But given the scale of the need, there’s going to be no quick fix to the pandemic. Another vaccine candidate, developed by U.S. biotech firm Moderna with the National Institutes of Health, provoked the desired immune response in a test of 45 individuals, and is about to enter phase 3 trials. It functions by introducing an mRNA sequence—a molecule that tells cells what to build—coded for a disease-specific antigen. Once produced within the body, the antigen is logged by the immune system, empowering it to fight the real virus. But while such RNA vaccines, as they’re known, have multiple benefits—including speed of production—they must be stored at sub-zero temperatures. That means their distribution to far-flung populations is problematic. While SinoVac initially experimented with RNA and other vaccine prototypes, they found that a traditional inactivated virus vaccine produced the best results. Under normal conditions, Yin believes CoronaVac has a shelf life of three years. “The purpose of this work is not to discover which technology is better,” says Yin. “The purpose is to control the disease.” In principle, SinoVac is a private company that owns CoronaVac as its licensed intellectual property, meaning where the vaccine is distributed should be a purely commercial decision. However, the Chinese government has contributed to the estimated one billion renminbi (about $140 million) the firm is investing in CoronaVac. This and other contributions from international NGOs currently under negotiation all come with distribution commitments attached. In a speech to the World Health Assembly on May 18, Chinese President Xi Jinping promised to make a COVID-19 vaccine produced in China a “global public good.” In reality, of course, every queue has someone at the back, meaning there will be much jostling for priority—and potentially boosting Beijing’s global clout. According to Benjamin N. Gedan, a former regional director on the White House’s National Security Council now with the Wilson Center, “If China produces the first coronavirus vaccine at scale, it would be an extraordinary diplomatic tool anywhere in the world.” SinoVac has already committed to sharing 60-100 million doses in Brazil through a collaboration with São Paulo-based Instituto Butantan, which is performing the phase 3 study. In Asia, the firm is “actively in discussion with several countries,” says Yin, including Indonesia and Turkey, and is exploring options in Europe. It has also had more than 30 meetings with the WHO to update the global health body on its progress. “We will share our vaccine with the world,” says Yin. from https://ift.tt/3jTuguK Check out https://takiaisfobia.blogspot.com/ Authorities in Spain prohibited anyone from entering or leaving the town of Totana in the southeastern part of the country yesterday, after 55 people who went to a local bar tested positive for COVID-19. The town, home to 32,000 people, is one of many in Spain to go back into lockdown, as the country struggles to contact trace and get a handle on new outbreaks popping up across the nation. Spain was home to one of Europe’s worst COVID-19 outbreaks, experiencing 270,166 cases and 28,429 deaths since January. The country also had the world’s highest reported rate of COVID-19 infection for doctors and nurses. But after four months in one of the strictest lockdowns on the continent, Spain lifted its state of emergency on June 21 amid lower case numbers and fatality rates, reinstating people’s freedom of movement and opening borders to some countries. A month later, Spain is facing another surge in cases. Widespread neglect of social distancing rules and limited contact tracing have driven spikes in new daily infection rates that has forced the government to place parts of the country under temporary lockdown again. Although other European countries like Germany and Portugal have also seen the number of new daily cases tick up, they have not been on the same scale as Spain. On Wednesday, 730 new infections were reported in Spain, the highest increase in new daily cases since May 8. Spanish health officials reported on July 20 that the infection rate has tripled in just over two weeks from 8.7 per 100,000 people infected on July 3, to 27.4 per 100,000 this week. Salvador Illa, Spain’s health minister, said on Wednesday that there are 224 local outbreaks throughout the country and warned that if they cannot be kept under control, he will be forced to call another state of emergency. Here is what to know: How did Spain handle its reopening?When Spain began slowly lifting its lockdown in early June, social distancing protocols were put in place. People were required to stay 1.5 meters (4.9 ft) apart in public and face masks were compulsory for anyone over the age of six if maintaining social distancing was not possible. Bars and restaurants opened with limited capacity as did cinemas, theatres and exhibitions. By June 21, Spain began lifting some border controls, and reopened its border with Portugal on July 1. But experts say that the rush to reopen the country to tourism may have led to a rise in new infection rates. “We faced a lot of pressure from the tourist industry because it’s one of the main economic sectors of Spain,” says Dr Jacobo Mendioroz, the director and coordinator of the committee responding to coronavirus in Catalonia. “We may have rushed into opening all the big stores, just to have tourists coming into our country.” Where have the outbreaks occurred?The first outbreaks were in care homes and slaughterhouses in Lleida, a city west of Catalonia. Two other northern regions, Galicia and Aragón, also experienced outbreaks. By July, thousands of seasonal workers from Morocco and sub-Saharan Africa working as fruit pickers in northeastern Spain also tested positive for the virus. The migrant workers live in overcrowded homes, making social distancing difficult, exacerbating the spread of the virus. But the infection rate appears to be rising particularly among teenagers. The number of people between the ages of 10 and 19 who tested positive with COVID-19 have increased sevenfold over the past month. While young people are less likely to require hospitalization if infected with COVID-19 than older patients, the spike in infections rates among this demographic remains concerning given young people’s potential to spread the virus to vulnerable populations. Getting younger people to socially distance, however, is challenging. “It’s hard to tell young people not to have gatherings together,” Mendioroz says. Why is Spain struggling to get a handle on new outbreaks?Many experts attribute these local outbreaks to a lack of contact tracing. People who have tested positive for the virus in Spain have reported that they were not asked to provide a list of people or establishments they came into contact with in the two weeks leading up to their diagnosis. Sonia Ramírez, a 21 year-old Spaniard from the northeast region of Catalonia, told the Associated Press that after testing positive for the virus, she independently had to warn family and friends of possible exposure. “They didn’t ask me who I had been with,” Ramírez told the AP. “They didn’t even ask if I had been to work recently, which of course I had.” The virus is also spreading quickly as a result of people and establishments failing to follow social distancing protocols. A club in Barcelona, for instance, has been accused by regional officials for allowing more people into their establishment than permitted, resulting in 91 people testing positive with the virus (club officials insist they followed the guidelines). Whether large cities like Barcelona will have to lockdown remains a question. Ada Colau, the left-wing mayor of Barcelona, has cautioned that the government is considering bringing in some restrictions for inhabitants of the city but says it will not return to a full lockdown as it did in March. The uptick in new cases has neighbouring countries worried. Jean Castez, the new French Prime Minister, has warned that France may be forced to close its borders with Spain if numbers continue to rise. “This is an issue we are following closely,” Castez said while visiting Prades, a French city on the border of Spain. What can other countries learn?Although other countries can learn from Spain’s mistakes with contact tracing and opening border too quickly, Mendioroz says that the key to curbing the spread of the virus is clear communication with the public about the pandemic. “We didn’t manage to communicate well that this pandemic will last a long time and that the protective measures should be implemented at all times,” he says. “I think the more we can communicate that the pandemic can be maintained through collective responses instead of through authoritarian measures, the more people will be joining this kind of safe behaviour.” from https://ift.tt/3jy6Yuh Check out https://takiaisfobia.blogspot.com/ Pandemics can be indiscriminate, with viruses making no distinctions among the victims they attack and those they spare. If you’re human, you’ll do. COVID-19 has been different, particularly when it comes to age. The disease has shown a special animus for older people, with those 65-plus considered at especially high risk for hospitalization and death, and those 18 and below catching a semblance of an epidemiological break. Though a small share of adolescents have suffered severe cases, most who contract the disease in that age cohort are likelier to experience milder symptoms or none at all. But if COVID-19 is sparing most kids’ bodies, it’s not being so kind to their minds. Nobody is immune to the stress that comes with a pandemic and related quarantining. Children, however, may be at particular risk. Living in a universe that is already out of their control, they can become especially shaken when the verities they count on to give the world order–the rituals in their lives, the very day-to-dayness of living–get blown to bits. “I worry that kids will get a double wallop,” says Ezra Golberstein, a health-policy researcher at the University of Minnesota. “There’s the disease itself and the fear of it. On top of that, you’ve got the lock-downs, with kids removed from the school environment and their friends.” As summer approached, many of the 12,000 camps in the U.S. either postponed their seasons or canceled them altogether, further leaving children isolated. “Especially for kids predis-posed to seeing the world in pessimistic terms, there will be more anxiety because they feel so much more out of control,” says Mary Alvord, a Maryland-based psychologist specializing in children, and co-author of Resilience Builder Program for Children and Adolescents. “We’re hearing kids say, ‘I’m afraid for myself, for my parents. What if we get sick?'” Now, as the next school year approaches, there’s even more uncertainty. The U.S. Centers for Disease Control and Prevention (CDC) has issued guidelines for schools, analyzing the comparative infection risks for three different scenarios: continuing all-remote learning (what it calls “lowest risk”); mixing some remote learning with inperson classes and social distancing (“more risk”); and resuming full-time attendance (“highest risk”). It’s impossible to say which states will choose which approaches, but already, the massive Los Angeles and San Diego school systems have announced that they will begin the school year with remote learning only–a decision that means yet more quarantining for 825,000 students. They surely won’t be the only ones. For now, there is a dearth of hard research on how the pandemic is affecting children’s mental health, mostly because the virus has been so fast-moving and studies take time. What data does exist is troubling. In one study out of China, published in JAMA Pediatrics, researchers in Hubei province, where the pandemic originated, examined a sample group of 2,330 schoolchildren for signs of emotional distress. The kids had been locked down for what, to quarantine-weary Americans, likely seems like a relatively short period–an average of 33.7 days. Even after that single month, 22.6% of them reported depressive symptoms and 18.9% were experiencing anxiety. Then too there is the other sickly victim of the pandemic: the economy, which continues to struggle badly. In a 2018 paper published in Health Economics, Golberstein and his co-authors studied economic conditions in the U.S. from 2001 to 2013 and found that during the Great Recession, a 5-percent-age-point increase in the national unemployment rate correlated with an astounding 35% to 50% increase in “clinically meaningful childhood mental-health problems.” With unemployment now exceeding 11%–compared with 3.6% in January–Golberstein expects to see more of the same emotional blowback. “When the economy is in a bad place, kids’ mental health gets worse,” he says. “This time is going to be much worse because it’s also a pandemic.” Lisa Stanton lives in Houston with her husband and their 9-year-old fraternal twins. Both parents are employed and have been working from home–though Stanton’s husband has been able to go back to his on-site work as a property manager–and both children have been home from school. With their summer camp shuttered for the season, the kids have remained homebound and the household environment has grown … challenging. “I’m seeing 100% more behavioral problems,” says Stanton. “My son, who has learning issues, has three meltdowns a day. With my daughter, the problem became addiction to the iPad. She has a TikTok account and created an [alias] of an older girl. We took the tablet away, and there were hysterics. She told us, ‘I want to be on the tablet all the time because [when I am] I don’t feel so lonely.'” Loneliness in lockdown is common for kids separated from their friends. But all children will not be emotionally rattled by the pandemic equally–or even at all; COVID-19 will affect them to different degrees and in different ways. Roxane Cohen Silver, a social psychologist at the University of California, Irvine, specializes in human responses to mass trauma and has most closely studied the Sept. 11 attacks in the U.S. and the 2006 and 2010 earthquakes in Indonesia and Chile, respectively. Though nobody in any culture does especially well in a time of such tragedy, Silver has found that the closer individuals are to a crisis–both geographically and personally–the greater the impact. People in New York City and Washington, D.C., had more acute reactions to 9/11 than people more removed from the terrorist strikes. The coronavirus is similarly hitting some people harder than others. “The impact on a child’s sense of safety depends on the extent to which the family is affected,” Silver says. “If there is a loss or if the family has a drastic change in their economic consequences, this event would shape the children’s view of the world.” But being able to avoid personal loss is not the same as avoiding the fear of it, and children are very much aware of what’s at stake. “I have a grandma and a grandpa who are very old, and it can infect them and they may die,” said 4-year-old Benjy Taksa of Houston, in a very brief mom-supervised interview with TIME. Lisa Taksa, Benjy’s mother, says her son doesn’t otherwise seem anxious about the pandemic, and to the extent he does, he is finding ways to cope. “In his play I’ll hear him say, ‘This bear is going to the museum, and he has to wear his mask,'” she says. Another variable is whether a child came into the crisis with pre-existing mental-health problems. In the U.S., 7.1% of children in the 3-to-17 age group have been diagnosed with anxiety, according to the CDC. An additional 3.2% in the same age group suffer from depression. Then there are the 7.4% with diagnosed behavior problems and the 9.4% with ADHD. Silver found that in the aftermath of 9/11, adolescents’ level of distress closely tracked whether or not they had a history of such conditions. Other experts expect to see that pattern repeated because of COVID-19. “Children who were struggling before [the pandemic] are at higher risk now,” says psychologist Robin Gurwitch, a professor at Duke University Medical Center. “You have to be careful about kids who were already in mental-health services; we have to make sure services aren’t disrupted.” Adults and children in therapy with private mental-health professionals may go right ahead Zooming or Skyping their sessions with no interruption in treatment. But some kids don’t have the opportunity. In an April editorial published in JAMA Pediatrics, Golberstein and his co-authors reported that according to an analysis of 2014 data, 13.2% of adolescents received some form of mental-health services in the school setting in the preceding 12 months (a figure that is more or less the same today). Their further analysis of data from 2012 to 2015 showed that among all students who received any mental-health services, 57% got a portion of it at school while 35% received all of it there. With schools shut down, so is the care. And, as things stand, there’s no guarantee which schools will reopen in the fall. “I worry about what this is doing to kids,” says Golberstein. “The extent to which they are able to access mental-health care is always a challenge. There’s a long-standing shortage, and it’s worse with the school closures.” Age can also be a big factor in how hard the pandemic hits kids emotionally. Very small children might not notice anything is different except that their parents aren’t going to work, which may seem like all upside. “For younger children, being with their parents full-time is seen as a plus,” says Silver. But those same younger kids have acutely twitchy antennae when it comes to reading the anxious mood of the older people around them. The ambient stress in a locked-down household in which parents are fretting, perhaps quarreling, and disinfecting everything that doesn’t move does not go unnoticed by children. “In very young children, you might see more clinginess,” says Gurwitch. “Kids are going to have a harder time sleeping. In children who have been potty-trained, you may see regression and accidents. This is not,” she adds, “a recipe for ease or joy.” For schoolagers and teens, being with parents is all downside, and being with friends is everything. In the case of the pandemic, that essential socializing is out of the question. Silver points out that one of the things that helped Americans rebound after the 9/11 attacks was a sort of great cultural coming together–precisely what can’t happen now. “People congregated and went to their houses of worship, and there were memorials,” she says. “For children, being restricted from gathering with friends at a time they may most want to spend time with them makes this event very different.” If there is one thing that’s certain about the impact of the pandemic on the young mind, it’s that it’s not going to stop until the spread of COVID-19 itself does. For parents and other caregivers, that means mitigating the problem, not mending it altogether. One important step: dial back the media–especially TV news. Thomas Cooper, professor of media ethics at Emerson College in Boston, sees an important precedent in the coverage of the Sept. 11 attacks–and it troubles him. “During 9/11, we found that the prime-time coverage of airplanes flying into World Trade Center buildings with people jumping out of windows led to something that you might call emotional poisoning,” he says. “People saw it again and again and again and again, and there was a kind of totally demoralizing effect. When you hear about COVID-19 again and again and again and again, all of that leads to a kind of emotional poisoning too.” How much coverage any one home should allow depends, again, on the age of the kids. “‘Littles’ shouldn’t be exposed to this at all,” Gurwitch says. “Don’t think that when they’re drawing or playing a game with you while you’re watching TV that they’re not listening.” For older kids who have a greater sense of the unfolding crisis, Gurwitch still recommends a limited TV diet. More important, she argues for open communication in which parents ask their children what they know–or think they know, correct them when they’re wrong and validate their fears. Thinking about precautions like social distancing as ways to behave proactively can also help kids regain some sense of control. “It can be framed as ‘Here’s what we’re doing to keep our families safe and keep others safe, and make sure health care workers don’t have to worry about us,'” Gurwitch says. Eventually, the pandemic will assume its place in the canon of national traumas, alongside 9/11, the Challenger disaster and the Kennedy assassination. The young generation living through coronavirus now will have the same conversations with their peers as they get older–the do-you-remember and where-were-you-when exchanges–as earlier generations have had about those other tragedies. For some, the memories will be of a more private pain. The goal, for parents and professionals and other caregivers, is to help ease that pain, to make the now more bear-able for kids, so that the memories will be too. from https://ift.tt/2WQoUX0 Check out https://takiaisfobia.blogspot.com/ Softening his earlier stance, President Donald Trump on Thursday acknowledged that some schools may need to delay their reopening this fall as the coronavirus continues to surge. It marks a shift from Trump’s previous demand for a full reopening of the nation’s schools. In recent weeks, Trump has said that it’s safe to open schools and that Democrats have opposed it for political reasons. But speaking at a White House news conference, Trump said districts in some virus hot spots “may need to delay reopening for a few weeks.” He said the decision will fall to governors. Even as he tempered his position, though, Trump insisted that every school should be “actively making preparations to open.” Students need to be in school buildings to prevent learning setbacks, he said, and to access meal programs and mental health services. As long as they have necessary measures in place, he added, “many school districts can now reopen safely.” Trump has made opening schools a key priority as he looks to restart the economy. Students need to return to the classroom so their parents can return to work, he has said. His push has at times put him at odds with his own health officials. Earlier this month, he said school guidelines from the Centers for Disease Control and Prevention were too tough, prompting the agency to promise updated guidance. The CDC on Thursday added new information to its website on opening schools, but it did not appear to remove any of its earlier suggestions. Much of the new material emphasized the importance of reopening schools, echoing many of Trump’s arguments. The updated guidance urged school leaders to work with local officials to make decisions about the fall, taking into account the virus’s rate of transmission in the area. It laid out a range of measures depending on the level of spread. If there’s minimal or moderate spread, it recommends social distancing, masks and increased sanitation. But in areas with substantive and uncontrolled spread, it says, school closure is an “important consideration.” “Plans for virtual learning should be in place in the event of a school closure,” the CDC said. Some of the nation’s largest districts have already rejected the idea of a full reopening. The Los Angeles and San Diego districts plan to keep classes online this fall, while New York City’s schools plan to offer a mix of online and in-person instruction. Education Secretary Betsy DeVos has said that students should be in the classroom every day if their families want and that any alternative fails students and taxpayers. In many states, education leaders have said they want to return to school but lack the funding to implement safety measures. A group of state education chiefs has said U.S. schools would need more than $200 billion to prepare for a fall reopening. Trump on Thursday said he’s asking Congress to provide $105 billion in education funding as part of the next virus relief bill. It’s meant to help schools reduce class sizes, hire teachers, rearrange spaces and provide masks, he said. But if a local district doesn’t open, Trump said, the money should be steered to parents so they can pursue other education options. “If schools do not reopen, the funding should go to parents to send their children to the public, private, charter, religious or home school,” he said. “All families should be empowered to make the decision that is right for their circumstance.” Responding to his proposal, the president of one of the nation’s largest education unions said Trump was “sowing seeds of chaos and confusion so he can fulfill his and Betsy DeVos’ dream of privatizing and voucherizing public education.” “He’s provided no plan and no funding and has ignored the health experts,” said Randi Weingarten, president of the American Federation of Teachers. “Teachers won’t let him get away with it.” from https://ift.tt/3g7wsfy Check out https://takiaisfobia.blogspot.com/ With medical grade masks still in short supply and badly needed at hospitals and other care centers, many Americans have turned to a variety of other options to help slow the spread of COVID-19, from hand-sewn facial coverings to bandanas and everything in between. But it turns out that when it comes to preventing viral transmission, not all masks are created equal, according to a new study. In the study, published Thursday in the journal Thorax, researchers pitted three kinds of facial coverings against one another: a single-layer “no sew” mask, a two-layer variety made to specifications from the U.S. Centers for Disease Control and Prevention (CDC), and a three-layer surgical mask. Using LED lights, a high-speed camera and a healthy volunteer willing to have their nose repeatedly ticked with a tissue, each variety of facial covering was tested to see which best contained droplets generated from speaking, coughing and sneezing, with the idea that better containment suggests better efficacy in terms of curbing transmission. “The COVID-19 pandemic and the need for community face masks has raised questions about whether you can just throw a scarf over your face, or whether you should use a better designed cloth mask,” says Raina MacIntyre, a professor of global biosecurity at the University of New South Wales Sydney, and one of the study’s authors. The result? The surgical mask did the best job overall, but the two-layer CDC mask was still “significantly better” at containing droplets than the single-layer covering. However, the researchers added, “even a single-layer face covering is better than no face covering.” The results were somewhat unsurprising. Surgical masks are made of multi-layered polypropylene with a water-resistant outer layer, and they’re regulated based on their ability to catch droplets, MacIntyre explains. And the researchers knew from prior studies that cloth masks with more layers generally perform better. “In truth you probably need at least 3 layers,” says MacIntyre. Other factors, like the material, design, fit, and how frequently a mask is washed, also make a difference. This new study follows a similar effort last month, which found that commercially available cone-style masks and quilted, multi-layer homemade masks that were properly fitted did the best job of containing respiratory droplets, while “loosely folded face masks” and bandanas “provide minimal stopping capability for the smallest aerosolized respiratory droplets.” Still other studies have the need for facial coverings abundantly clear. Research published in June found that mask mandates in U.S. states were associated with faster declines in daily COVID-19 case growth, estimating that mask rules prevented up to 450,000 cases through late May. A different study, also published in June, predicted that the U.S. could avoid more than 30,000 coronavirus-related deaths though October if at least 95% of people wear masks in public, while another study found that mask wearing could reduce transmission risk from about 17% to roughly 3%. Of course, the comparative efficacy of various types of facial coverings doesn’t matter if people aren’t covering their faces to begin with. While some cities and states have issued mandatory mask rules, many have not, and the Trump Administration has been reluctant to issue a national mandate. The issue has been politicized across the U.S., perhaps best illustrated by Georgia governor Brian Kemp’s July 16 lawsuit challenging Atlanta’s mask rules and other restrictions despite a worsening outbreak across the state. Still, most registered U.S. voters now support statewide mask mandates, according to a Politico poll released Wednesday. For those committed to wearing face coverings in order to help keep themselves and others safe, it’s important to know that just tucking your face into your t-shirt might not cut it. “The main message is that the design of your cloth mask matters—more layers is better than just one layer,” says MacIntyre. She recommends making masks with a water-resistant fabric, like polyester, for an outer layer, as well as having at least three layers and ensuring a good facial fit. “Most importantly,” she adds, “always use a clean mask and wash your used mask daily.” from https://ift.tt/32JKa4G Check out https://takiaisfobia.blogspot.com/ Tori Geib was already on high alert when COVID-19 hit last winter. Diagnosed with metastatic breast cancer in 2016, the Ohio chef went from one chemotherapy regimen to another in an effort to outrun the cancer that had spread from her breast to her bones, lungs and liver. To protect her-self from infections, even before the pandemic she often wore masks when she went out in public and carried hand sanitizer at all times. But COVID-19 presented a new and daunting challenge. At some point, Geib knew, she would exhaust all approved treatment options and would need to move to experimental therapies. But when COVID-19 began to burden hospitals, many suspended clinical trials. “It made what limited options I had even more limited,” she says. “When your cancer is growing and progressing, you want to know what the next thing is that you will have access to. COVID-19 brought in a new fear: Will that research or trial be there when I need it?” Three months ago, Geib learned her cancer had progressed, so she again changed to a different chemotherapy. At the end of June, she learned the cancer had spread to her brain, so she received radiation treatment. She is also taking another off-label therapy while waiting for more clinical trials to become available near where she lives. “I’m trying to navigate the system and find the next thing I need to go to.” Estimates of how many cancer patients enroll in clinical trials range from 2% to 8%. But since the pandemic began, the National Cancer Institute (NCI), which sponsors many cancer trials in the U.S., says enrollment in trials has dropped by about 10% each month. The potential impact is profound. “First, it’s a missed opportunity for patients to actually avail themselves of participating in a clinical trial if the trial is on hold or temporarily suspended or even closed,” says Dr. Richard Schilsky, chief medical officer and executive vice president of the American Society of Clinical Oncology. “The longer[-term] impact is that the time to complete trials is going to be longer than originally planned because enrollment has taken a big dip for a period of months, and it will take time to make that up. That means it will take longer to get an answer to a trial and longer to potentially bring new therapies to patients.” With limited resources, many study sites decided to triage their clinical trials, suspending early-phase studies, in which the benefit of the experimental treatment is largely unknown, in favor of keeping later-stage studies, which test treatments that have already shown some promise. “All of these decisions are based on benefit-risk assessment,” says Schilsky. “What is the risk of interrupting, delaying or discontinuing a patient on a cancer treatment, especially if they have an aggressive, rapidly progressive cancer, vs. the risk of continuing treatments that require them to come into a health care facility for frequent visits, risking exposure to COVID-19 infection?” Normally, study conditions require patients to come to the trial site to receive their medications along with instructions on how to take them. To keep some trials going during the pandemic, the Food and Drug Administration and the NCI worked to allow study sponsors to ship experimental therapies directly to patients. Similarly, virtual checkups replaced in-person visits when possible, further reducing COVID-19 risk for trial participants. Time will tell how those changes affect the results of clinical trials; for example, it’s possible the lack of medical oversight will affect compliance with taking medications. But Schilsky notes there may be a silver lining. “Many of the adaptations make it easier for patients to participate in clinical trials,” he says. “So if they work, there may be no reason to go back to the old way of doing things. Hopefully the adaptations made during the pandemic will position us to do clinical trials more effectively than they’ve been done in the past and ultimately open them up to more patients.” from https://ift.tt/3f1Wwru Check out https://takiaisfobia.blogspot.com/ |
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